W. Hamilton
For which cancers might patients benefit most from expedited symptomatic diagnosis? Construction of a ranking order by a modified Delphi technique
Hamilton, W.; Stapley, S.; Campbell, C.; Lyratzopoulos, G.; Rubin, G.; Neal, R.D.
Authors
S. Stapley
C. Campbell
G. Lyratzopoulos
G. Rubin
R.D. Neal
Abstract
Background This study aimed to answer the question ‘for which cancers, in a symptomatic patient, does expediting the diagnosis provide an improvement in mortality and/or morbidity?’ Methods An initial ranking was constructed from previous work identifying ‘avoidable deaths’ for 21 common cancers in the UK. In a two-round modified Delphi exercise, 22 experts, all experienced across multiple cancers, used an evidence pack summarising recent relevant publications and their own experience to adjust this ranking. Participants also answered on a Likert scale whether they anticipated mortality or morbidity benefits for each cancer from expedited diagnosis. Results Substantial changes in ranking occurred in the Delphi exercise. Finally, expedited diagnosis was judged to provide the greatest mortality benefit in breast cancer, uterine cancer and melanoma, and least in brain and pancreatic cancers. Three cancers, prostate, brain and pancreas, attracted a median answer of ‘disagree’ to whether they expected mortality benefits from expedited diagnosis of symptomatic cancer. Conclusions Our results can guide future research, with emphasis given to studying interventions to improve symptomatic diagnosis of those cancers ranked highly. In contrast, research efforts for cancers with the lowest rankings could be re-directed towards alternative avenues more likely to yield benefit, such as screening or treatment.
Citation
Hamilton, W., Stapley, S., Campbell, C., Lyratzopoulos, G., Rubin, G., & Neal, R. (2015). For which cancers might patients benefit most from expedited symptomatic diagnosis? Construction of a ranking order by a modified Delphi technique. BMC Cancer, 15, Article 820. https://doi.org/10.1186/s12885-015-1865-x
Journal Article Type | Article |
---|---|
Acceptance Date | Oct 27, 2015 |
Publication Date | Oct 30, 2015 |
Deposit Date | Jan 26, 2016 |
Publicly Available Date | Jan 27, 2016 |
Journal | BMC Cancer |
Electronic ISSN | 1471-2407 |
Publisher | BioMed Central |
Peer Reviewed | Peer Reviewed |
Volume | 15 |
Article Number | 820 |
DOI | https://doi.org/10.1186/s12885-015-1865-x |
Keywords | Cancer, Diagnosis, Primary health care, Modified Delphi technique. |
Public URL | https://durham-repository.worktribe.com/output/1394165 |
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http://creativecommons.org/licenses/by/4.0/
Copyright Statement
© 2015 Hamilton et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
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